Archives: Clinical Corner

If you were diagnosed with hypertension (high blood pressure) today, you would most likely seek treatment for your health condition. However, according to the American Psychiatric Association, over half of all people experiencing mental illness do not seek or receive help for their condition. Why? Persons experiencing mental health crises fear judgment, retaliation, and discrimination if they seek help and become labeled as suffering from a mental health concern. Mental Health Month, and the work we do every day of the year, is so critically important in reducing stigma.

Research has shown that stigma reduction is a complementary modality to medication management and therapies for people struggling with a mental illness. According to the Lancet, people experiencing mental illness often describe the shame of having a mental illness, the ostracism from society, and being placed into a category of people who are seen as less than others is much worse than the mental illness itself.

This graphic shows how stigma intersects with stereotypes, prejudices, and discrimination (Corrigan, Pw, Druss, BG, Perlick, DA. The Impact of Mental Illness Stigma on Seeking and Participating in Mental Health Care. Psychological Science in The Public Interest. 2014, 15(2);37-70.):

	Public	Self	Institutional
Stereotypes & Prejudices	People with mental illness are dangerous, incompetent, to blame for their disorder, and unpredictable	I am dangerous, incompetent, and to blame	Stereotypes are embodied in laws and other institutions
Discrimination	Therefore, employers may not hire them, landlords may not rent to them, and the health care system may offer a lower standard of care	These thoughts lead to lowered self-esteem and self-efficacy: “Why try? Someone like me is not worthy of good health.”	Intended and unintended loss of opportunity

According to the American Psychiatric Association, there can be many harmful effects on persons with mental illness because of stigma:

• Reduced hope
• Lower self-esteem
• Increased psychiatric symptoms
• Difficulties with social relationships
• Reduced likelihood of staying with treatment
• More difficulties at work
• Reluctance to seek help or treatment and less likely to stay with treatment
• Social isolation
• Lack of understanding by family, friends, coworkers, or others
• Fewer opportunities for work, school, or social activities or trouble finding housing
• Bullying, physical violence, or harassment
• Health insurance that doesn’t adequately cover your mental illness treatment
• The belief that you’ll never succeed at certain challenges or that you can’t improve your situation

How can we combat stigma? According to NAMI, these actions can help with reducing stigma:

• Talk openly about mental health, such as sharing on social media.
• Educate yourself and others – respond to misperceptions or negative comments by sharing facts and experiences.
• Be conscious of language – remind people that words matter.
• Encourage equality between physical and mental illness – draw comparisons to how they would treat someone with cancer or diabetes.
• Show compassion for those with mental illness.
• Be honest about treatment – normalize mental health treatment, just like other health care treatments.
• Let the media know when they are using stigmatizing language to present stories of mental illness in a stigmatizing way.
• Choose empowerment over shame – “I fight stigma by choosing to live an empowered life. That means owning my life and my story and refusing to allow others to dictate how I view myself or how I feel about myself.” – Val Fletcher, responding on Facebook to the question, How do you fight stigma?

Thank you for all you are doing to reduce stigma and increase access and treatment for those experiencing a mental health crisis. Your work is meaningful, and we are making a difference!

The second week of Mental Health Month is also National Prevention Week for Mental Health and Substance Abuse. The mental and emotional well-being of healthcare professionals has been in the spotlight since the pandemic arose, but mental health and addiction issues amongst our professions are longstanding. It is important to be aware of the challenges that healthcare workers face while we highlight reducing stigma in mental health treatment. It could be ourselves or our coworkers needing mental health support. Healthcare workers’ fears of retaliation, worry about job stability, or fear of losing licensure can prevent them from seeking help. Here are some sobering statistics that highlight the need to not only have these conversations amongst ourselves but also to advocate for supportive services for healthcare professionals.

Statistics & Facts on Substance Use and Mental Health Concerns in Social Workers (from the National Library of Medicine)

• A 2015 survey of 6,112 licensed social workers in 13 states was conducted regarding their problems with mental health; alcohol, tobacco, other drugs, and gambling.
• Results indicate that 40.2 percent of respondents reported mental health problems before becoming social workers, increasing to 51.8 percent during their social work career, with 28 percent currently experiencing such problems.
• Nearly 10 percent of the sample experienced substance use problems before becoming social workers, decreasing to 7.7 percent during their career.

Statistics on Mental Health Concerns in Nurses (from the Robert Wood Foundation Interdisciplinary Nursing Quality Research Initiative)

• Nurses experience clinical depression at twice the rate of the general public.
• Depression affects 9% of everyday citizens, but 18% of nurses experience symptoms of depression.
• In a study of 332 nurses, 22% had symptoms of PTSD (with 18% meeting diagnostic criteria for PTSD), and 86% met the criteria for Burn Out Syndrome. 98% of the nurses with PTSD also had Burn Out Syndrome.

Statistics & Facts on Substance Use in Nurses (from the Iowa Board of Nursing)

• The rate of nurses’ substance use is comparative with the general population estimates of substance use, between 6% and 8%.
• 18 % of nurses showed signs of substance use, while one-third (6.6% of the entire population) qualified for a substance use disorder.
• Substance use may still be stigmatized in the field of nursing. Many nurses who recover from substance use issues tend to feel stressed about re-entering the healthcare field because of the restrictions placed on them upon reentry (more restrictive schedules, drug testing, monitoring, and required attendance at support meetings, like AA).
• Many nurses report using substances to cope with stressors or watching peers cope with stress by using substances.
• Illicit and prescription drug use are most common in home health and hospice nurses and nurses in nursing homes.

Statistics & Facts on Substance Use in Physicians (from the National Library of Medicine)

• Out of 7,288 physicians studied, 12.9% of male physicians and 21.4% of female physicians met diagnostic criteria for alcohol abuse or dependence.
• Abuse of prescription drugs and illicit drugs was rare amongst physicians.
• Alcohol abuse or dependence is a significant problem among American physicians.

As you can see, we have work to do with ourselves and with the patients who seek us out for support. Here are some resources for some events that are upcoming that can support us both personally and professionally:

• Caring for Your Mental Health by the National Institute of Mental Health
• HHS’s New Mental Health and Substance Use Disorder Benefit Resources Will Help People Seeking Care to Better Understand Their Rights
• The U.S. Department of Housing and Urban Development’s (HUD) Office of Public and Indian Housing (PIH) and the U.S. Department of Health and Human Services (HHS) Substance Abuse and Mental Health Services Administration (SAMHSA) are teaming up to present a series of FREE webinars this May to celebrate National Mental Health Awareness Month! The webinars will take place each Wednesday in May from 1:00–2:00 pm (ET). They will feature leading mental health and housing professionals from SAMHSA and HUD and practitioners from their respective communities. This collaboration will focus on mental health issues our nation faces in the post-pandemic world, plus issues specific to HUD’s communities.
• Webinar 2: 988 is Not a Joke – National Suicide Prevention Hotline Launch – May 11, 2022 – SAMHSA and HUD will introduce SAMHSA’s new Suicide Prevention Hotline (988). The webinar will also address suicide prevention for youth and the BIPOC community and touch on substance use. Access Code: 8477433#
• Webinar 3: Get Help – Reducing Stigma Associated with Mental Health – May 18, 2022 – SAMHSA and HUD will focus on reducing the stigma associated with mental health to encourage those with potential mental health issues to seek professional help. This webinar will also concentrate on the BIPOC community, addressing stigma specific to these populations. Access Code: 5955873#
• Webinar 4: Now What? – Mental Health Issues in Post-COVID America – May 25, 2022 – SAMHSA and HUD will examine how to address mental health issues in post-COVID America. Besides the physical toll the pandemic took on Americans, it has also greatly affected our nation’s mental health. This webinar will discuss handling and moving past multiple co-occurring pandemics, using a mental health focus on substance use disorder, housing, work, education, and transportation, among other relevant topics. Access Code: 6268721#

Thank you for taking your self-care as seriously as you take the care of others. You are worth it!

This week kicks off Mental Health Month (MHM) 2022. If this is the first May you have been on the PMC/ITP team, you are in for a great month! Every year our teams work diligently to stop the stigma and raise awareness of mental illness and its treatments in May. The pandemic’s effects make MHM even more important. According to WHO, far from being an equalizer, the COVID-19 pandemic has exposed just how vulnerable many of our social and health systems are in the face of major public health shocks. The impact of coronavirus on people from marginalized communities, particularly those with behavioral health conditions, who are experiencing disproportional health, economic, and social impacts from the evolving pandemic has been extreme. Let’s look at the prevalence of mental illness in America (according to the NIMH):

Any mental illness (AMI) is defined as a mental, behavioral, or emotional disorder. AMI can vary in impact, ranging from no impairment to mild, moderate, and even severe impairment.

Prevalence of AMI:

• In 2020, there were an estimated 52.9 million adults aged 18 or older in the United States with AMI. This number represented 21.0% of all U.S. adults.
• The prevalence of AMI was higher among females (25.8%) than males (15.8%).
• Young adults aged 18-25 years had the highest prevalence of AMI (30.6%) compared to adults aged 26-49 years (25.3%) and aged 50 and older (14.5%).
• The prevalence of AMI was highest among the adults reporting two or more races (35.8%), followed by White adults (22.6%). The prevalence of AMI was lowest among Asian adults (13.9%).

Mental Health Services – AMI:

• In 2020, among the 52.9 million adults with AMI, 24.3 million (46.2%) received mental health services in the past year.
• More females with AMI (51.2%) received mental health services than males with AMI (37.4%).
• The percentage of young adults aged 18-25 years with AMI who received mental health services (42.1%) was lower than adults with AMI aged 26-49 years (46.6%) and aged 50 and older (48.0%).

Serious mental illness (SMI) is defined as a mental, behavioral, or emotional disorder resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities. The burden of mental illnesses is particularly concentrated among those who experience disability due to SMI.

Prevalence of SMI:

• In 2020, there were an estimated 14.2 million adults aged 18 or older in the United States with SMI. This number represented 5.6% of all U.S. adults.
• The prevalence of SMI was higher among females (7.0%) than males (4.2%).
• Young adults aged 18-25 years had the highest prevalence of SMI (9.7%) compared to adults aged 26-49 years (6.9%) and aged 50 and older (3.4%).
• The prevalence of SMI was highest among the adults reporting two or more races (9.9%), followed by American Indian / Alaskan Native (AI/AN) adults (6.6%). The prevalence of SMI was lowest among Native Hawaiian / Other Pacific Islander (NH/OPI) adults (1.2%).

Mental Health Services – SMI:

• In 2020, among the 14.2 million adults with SMI, 9.1 million (64.5%) received mental health treatment in the past year.
• More females with SMI (69.9%) received mental health treatment than males with SMI (54.9%).
• The percentage of young adults aged 18-25 years with SMI who received mental health treatment (57.6%) was lower than adults with SMI aged 26-49 years (63.0%) and aged 50 and older (72.9%).

These sobering statistics point out the work still to be done. The work you do this month will be important in spreading awareness and reducing stigma for those living with mental illness. I am looking forward to hearing about the amazing events you are hosting and the lives you are touching.

I appreciate all you do to make those living with mental illness live better lives!

According to the World Health Organization (WHO), every year, 703,000 people die by suicide, and many more people attempt death by suicide. Every death by suicide is a tragedy that affects families, communities, and entire countries and has long-lasting effects on the people left behind. Death by suicide occurred throughout the lifespan and was the fourth leading cause of death among 15–29-year-olds globally in 2019. Death by suicide does not just occur in high-income countries but is a global phenomenon in all regions of the world. In fact, over 77% of global deaths by suicide occurred in low- and middle-income countries in 2019. Death by suicide is a serious public health problem; however, suicides can be prevented with timely, evidence-based, and often low-cost interventions. 

While the link between suicide and mental disorders (in particular, depression and alcohol use disorders) is well established in high-income countries, many deaths by suicide happen impulsively in moments of crisis with a breakdown in the ability to deal with life stresses, such as financial problems, relationship break-up or chronic pain and illness. In addition, experiencing conflict, disaster, violence, abuse, or loss and a sense of isolation are strongly associated with suicidal behavior. According to the WHO, death by suicide rates are also high amongst vulnerable groups who experience discrimination, such as refugees and migrants, indigenous peoples, lesbian, gay, bisexual, transgender, intersex (LGBTI) persons, and prisoners. By far, the strongest risk factor for suicide is a previous suicide attempt.

The WHO has produced 2-page handouts for most settings (school, work, news media, etc.) on how to identify and help decrease the risk for suicide in the people in their influence. These are a great resource for your communities.

Here is a wonderful article that goes in depth about the myths around death by suicide and how to identify those at risk for family members and loved ones of the person contemplating death by suicide.

Thank you for all the work you continue to do to spread awareness of Suicide Prevention Month!

The month is almost half over, and we are making strides in our communities – way to go! Let’s jump into this week’s discussion points.

The highest rates of adolescent and young adult death by suicide happen amongst LGTBQ+ youth. According to the Trevor Project:

• LGB youth seriously contemplate suicide at almost three times the rate of heterosexual youth.
• LGB youth are almost five times as likely to have attempted suicide compared to heterosexual youth.
• Of all the suicide attempts made by youth, LGB youth suicide attempts were almost five times as likely to require medical treatment than heterosexual youth.
• Suicide attempts by LGB youth and questioning youth are 4 to 6 times more likely to result in injury, poisoning, or overdose that requires treatment from a doctor or nurse, compared to their straight peers.
• In a national study, 40% of transgender adults reported having made a suicide attempt. 92% of these individuals reported having attempted suicide before the age of 25.
• LGB youth who come from highly rejecting families are 8.4 times as likely to have attempted suicide as LGB peers who reported no or low levels of family rejection.
• 1 out of 6 students nationwide (grades 9–12) seriously considered suicide in the past year.
• Each episode of LGBT victimization, such as physical or verbal harassment or abuse, increases the likelihood of self-harming behavior by 2.5 times on average.

According to the NIH, death by suicide is the second leading cause of death among adolescents and young adults in the U.S. To address the need to reduce suicide deaths, researchers have focused their efforts on identifying treatments for those at high risk and learning more about the mechanisms that make treatments work best. A recent study showed that the emotional regulation achieved through dialectical behavioral therapy (DBT) reduced their suicide risk. Read more about this encouraging data.

In addition to this work by the NIH, the Trevor Project conducts its own research and offers evidence-based solutions on their website:

According to the CDC in 2019:

• 12 million American adults seriously thought about suicide
• 3.5 million made a plan to commit suicide
• 1.4 million attempted suicide

The CDC has created a plan for suicide reduction in the United States and offers great resources for suicide prevention.

PsychHub has created lots of resources for suicide prevention for professionals. You can take classes, get infographics, downloadable guidebooks, and YouTube videos.

Thank you for all you do to increase awareness of suicide prevention!

I hope you had a great Labor Day weekend! As we enter the second week of Suicide Prevention Month, death by suicide remains the 10^th leading cause of death in the United States. Let’s look at how the statistics vary based on location, gender, and method for ending life according to the CDC:

• Suicide rates for urban and rural areas increased overall from 2000 through 2018, increasing for rural suicide rates, compared with urban, after 2007.
• In 2018, the rural male suicide rate (30.7 per 100,000) was higher than the urban male suicide rate (21.5); the rural rate for females (8.0) was higher than the urban rate (5.9).
• Over the period 2000–2018, the rural male suffocation-related suicide rate more than doubled (3.7 compared with 8.8), and in 2018, the rural male firearm-related suicide rate (18.7) was 63% higher than the urban male firearm-related suicide rate (11.5).
• Over the period of 2000–2018, the rural female suffocation-related suicide rate more than quadrupled (0.5 compared with 2.4), and firearms remained the leading method of suicide in rural females.

Unfortunately, these numbers are going in the opposite direction of the way we would like. So many of us work or live in rural communities, and as you see above, the risk of death by suicide in rural communities is much higher than their urban counterparts. The work we do is so important!

This will be information that many of you know, but I feel it bears repeating because we can help prevent death by suicide.

The Suicide Prevention Resource Center defines risk, protective factors, and warning signs:

• Risk factors are characteristics that make it more likely that an individual will consider, attempt, or die by suicide.
• Warning signs indicate an immediate risk of suicide.
• Protective factors are characteristics that make it less likely that individuals will consider, attempt, or die by suicide.

Risk Factors for Suicide

Certain events and circumstances may increase risk (not in a particular order, except the first one).

• Previous suicide attempt(s)
• A history of suicide in the family
• Substance misuse
• Mood disorders (depression, bipolar disorder)
• Access to lethal means (e.g., keeping firearms in the home)
• Losses and other events (for example, the breakup of a relationship or a death, academic failures, legal difficulties, financial difficulties, bullying)
• History of trauma or abuse
• Chronic physical illness, including chronic pain
• Exposure to the suicidal behavior of others

Warning Signs of Suicide

• Often talking or writing about death, dying or suicide
• Making comments about being hopeless, helpless or worthless
• Expressions of having no reason for living; no sense of purpose in life; saying things like “It would be better if I wasn’t here” or “I want out.”
• Increased alcohol and/or drug misuse
• Withdrawal from friends, family and community
• Reckless behavior or more risky activities, seemingly without thinking
• Dramatic mood changes
• Talking about feeling trapped or being a burden to others

Protective Factors

• Contacts with providers (e.g., follow-up phone call from health care professional)
• Effective mental health care; easy access to a variety of clinical interventions
• Strong connections to individuals, family, community and social institutions
• Problem-solving and conflict resolution skills

We use these in our work with patients every day, and it makes a difference!

Here are some great resources to learn more on suicide prevention and to share with your communities:

You can attend NIMH Livestream Event on Suicide Prevention During COVID: A Continuing Priority. Register by clicking here.

You can attend a free two-day seminar, The Clinician’s Suicide Prevention Summit: Treatment Strategies to Inspire Hope and Save Lives.

Thank you for all you do!

Today kicks off Suicide Prevention Month. Every year, I look forward to September because of the amazing work we do to raise awareness of suicide risk behaviors and assist in suicide prevention in our communities. Unfortunately, the statistics remain sobering, and I will get into those in the coming weeks. This week I wanted to start with the power of language and communicate our messages to our communities this year.

In the past, some ways that people who died by suicide were reported on the news and in communities led to an increase in suicide deaths. We know that the way we communicate can escalate or deescalate a situation. The Suicide Prevention Research Center reviewed decades of research on this subject and provided us with these suggestions in communicating about suicide.

When providing public communication, remember these items:

• Portray help-seeking as a reasonable action.
• Provide resources people can choose to reach out for support.
• Give people who are willing to help others something to do.
• While you may want to communicate the issue’s importance, be careful not to normalize suicide.
• Emphasize that suicide can be prevented and treated successfully.
• Help distressed individuals to feel competent that they can do what needs to be done.
• Avoid giving very specific details of the tragedy.

Here are language substitutions we can make:

Say this	Instead of this
Died of suicide	Committed suicide
Suicide death	Successful attempt
Suicide attempt	Unsuccessful attempt
A person living with suicidal thoughts or behavior	Suicide ideator or attempter
Suicide	Completed suicide
(Describe the behavior)	Manipulative, cry for help, or suicidal gesture
Working with	Dealing with suicidal crisis

The work we do is so important. I look forward to seeing the amazing outreach work you will be doing this month.

I wanted to share a free training called Insights and Strategies for Reducing Suicide among Older Adults. You can read more about it and register by clicking the link.

Thank you for all you do to protect and improve the lives of so many!

This weekend we have been flooded with news and images of the situation occurring in Afghanistan. Our patient’s feelings about the situation are likely to come up in groups with our patients today, especially our veterans. Veterans are at increased risk for suicide, and we should be on alert to closely monitor our veteran patients.

The statistics are staggering:

• 20 veteran suicides in the United States each day. 14 of the 20 are not users of VA services. (2014 VA study)
• People who die by suicide are frequently experiencing undiagnosed, under-treated, or untreated PTSD/depression. (National Alliance on Mental Illness)
• 50% of those with PTSD do not seek treatment; out of the half that seek treatment, only half of them get “minimally adequate” treatment (RAND study)
• 55% of women in the military developed a form of PTSD from sexual harassment and assault. (National Center for PTSD) and 76% do not report sexual assault. (DoD SAPR)
• Veterans who live more than 70 miles away from services – typically those in rural areas – are twice as likely to die by suicide because they do not have the support network to maintain a positive frame of mind. (US Department of Veterans Affairs)

I wanted to provide you with several resources:

• Veterans Hotline – The Veterans Crisis Line is a free, confidential resource available to veterans, even if they are not enrolled in VA health care or registered with VA. They have means to call, text, or online chat.
• The US Department of Veteran Affairs – A website that speaks to the mental health conditions most frequently affecting veterans and provides video vignettes that could be used as a springboard for groups.
• National Center for PTSD – Great resources on understanding trauma and PTSD.
• If you are a veteran and struggling, and you are a PMC employee, you also have access to our Employee Assistance Program by calling 1-800-386-7055, emailing them at  ea**********@ib*****.com , or visiting the website at ibhworklife.com.

Thank you for all that you do to keep our patients safe!

I thought we would wrap up BIPOC Mental Health Month by focusing on how to be a good advocate. As persons working in healthcare, we often use the word ‘advocate.’ We use it when we are speaking with patients to empower them to speak up for their health care needs. We use it when we work with our patients on interpersonal relationships and how to make a space for their needs within them. What does it mean for us to be advocates as healthcare professionals?

Before we tackle what it means to be an advocate, let’s revisit why we need to be advocates:

“The American healthcare system has a long legacy of racism and discrimination, fuel for the disparity that is pervasive in this system. Navigating the healthcare system is daunting for most, but especially for BIPOC. Due to an array of access barriers, BIPOC not only receive less care than white people but also receive worse care. BIPOC are disproportionately misdiagnosed, under-diagnosed, and mistreated, quality of care directly correlates to worse health outcomes.”

Let that sink in – It is up to us, especially those who are privileged enough to have the system built around our skin color, to advocate for those the system was not built to care for.

Dr. Terri-Ann Bennett said it best, “Much like love, advocacy is an action word.” For us to advocate- it requires action on our part. Often, we want to help, and our hearts are in the right place, but we find we don’t know what steps to take. Here are steps TIA recommends to becoming an advocate for BIPOC:

• Personalizing medicine, rather than generalizing.
• Empowering patients through teaching and shared decision making.
• Reminding patients of their rights.
• Using communication styles that support understanding.
• Ensuring care continues after appointments (e.g., follow-ups, lifestyle changes, medication, etc.).

Another way we can become better advocates is by educating ourselves. When we encounter bias within ourselves or our teams, we must challenge ourselves and each other. We can be continual learners- attend anything we can to become more educated about healthcare disparity and what can be done.

This week the OMH is offering a free webinar Trauma and COVID-19: Addressing Mental Health Among Racial/Ethnic Minority Populations. Click through if you would like to attend.

You can go to the Office of Minority Health (OHM) website and register for their weekly email updates to become more knowledgeable.

I am grateful we had this month to have these conversations, but please use it as a springboard for the coming months to continue on the journey to becoming a healthcare advocate for all.

Thank you for all you do to make a difference!

This is the last full week of BIPOC Mental Health Month, so let’s make it count! Language is important. The words we use as professionals drive the care we provide and the outcomes we achieve. You might have noticed that most people have moved away from calling it ‘Minority Mental Health Month.’ Why? Here is what Mental Health America shared on the subject:

The continued use of “minority or marginalized” sets up BIPOC communities in terms of quantity instead of quality and removes their personhood. The word “minority” also emphasizes the power differential between “majority” and “minority” groups and can make BIPOC feel as though “minority” is synonymous with inferiority. Though “minority” and “marginalized” may continue to be used in academic spaces, the words the mental health community uses need to change to help.

One of the ways we reduce stigma is through language choice. This week let’s look at American Indians and Alaska Natives’ mental health statistics.

According to the US HHS Office of Minority Health:

Mental and Behavioral Health – American Indians/Alaska Natives

• In 2019, suicide was the second leading cause of death for American Indian/Alaska Natives between the ages of 10 and 34.
• American Indian/Alaska Natives are 60 percent more likely to experience the feeling that everything is an effort, all or most of the time, compared to non-Hispanic whites.
• The overall death rate from suicide for American Indian/Alaska Native adults is about 20 percent higher than the non-Hispanic white population.
• In 2019, adolescent American Indian/Alaska Native females, ages 15-19, had a death rate that was five times higher than non-Hispanic white females in the same age group.
• In 2018, American Indian/Alaska Native males, ages 15-24, had a death rate that was twice that of non-Hispanic white males in the same age group.
• Violent deaths, unintentional injuries, homicide, and suicide, account for 75 percent of all mortality in the second decade of life for American Indian/Alaska Natives.

These statistics, as well as the ones shared in previous weeks, are staggering. If you are like me, you wonder what I can do about it?

A great starting-off place is this website. It has great training, toolkits, webinars, and much more!

Additionally, last week the Joint Commission released a Quick Safety bulletin providing guidance on reducing heath disparity for diverse populations. Here is what they suggest for initiating and implementing change:

1. Leadership makes equity a strategic priority within your institution. This requires leaders to leverage policies and practices that embrace anti-racism both within and beyond the hospital walls, nurture partnerships and professional pipelines within communities, and intentionally address adverse social determinants of health.

2. Use a social intervention framework, such as CMS’ AHC model (mentioned above), to help identify the needs of your patient populations. The AHC model focuses on screening in 5 domains: housing instability, difficulty paying utility bills, food insecurity, transportation, and interpersonal violence. Your patient populations may have higher needs in some of these domains and lower or no needs in others. When needs in the community are identified, incorporate referrals to community resources and patient navigation (typically through a community health worker or patient navigator) in the social intervention framework you decide to use.

3. Create a strategic plan for community outreach. The plan should begin with an understanding of your organization’s culture, mission, vision, and values and an understanding of the patient populations that your organization serves. Identify opportunities to partner with the community and determine the level of involvement your organization would like to have with the community.

4. Support the local workforce. Organizations should make an effort to hire entry-level positions persons from their communities and provide advancement and professional development opportunities. This could potentially develop a pipeline for marginalized groups into health care professions, fostering career advancement and professional development for all employees.

Check out the website resources offered here today, and let me know what you learned!